Home Insurance Form
Name:
E-Mail:
Address:
Fax Nr:
Protection Code:
Please, enter the text shown in the image into the field below.
Insurance Form
Telephone No:
Claims must be submitted in writing within 72 hours after removal
PLEASE ARRANGE ALL RISK INSURANCE COVERAGE VALUE OF FURNITURE
PLEASE ARRANGE ADDITIONAL RESTRICTED TRANSIT INSURANCE COVERAGE VALUE OF FURNITURE
I AM NOT INTERESTED IN ANY FURTHER INSURANCE COVERAGE.
I INDEMNIFY THE REMOVAL FIRM FROM ANY RESPONSIBILITY OTHER THAN THW ABOVE MENTIONED RESTRICTED TRANSIT COVERAGE TO A MAXIMUM OF R 200 000.
Value: